Open Enrollment: An Overview of Week One

The fiscal year began on October 1st and although the partial government shutdown dampened what should have been a more festive moment in US healthcare, many states celebrated the opening of their eligibility systems and the official launch of health marketplaces. CMS offered support during the first week for ACA implementation activity, though some states reported having fewer interactions with the federal government due to the shutdown.

In general, the state experience reported largely functioning systems and a dramatic, but manageable uptick in web traffic and phone calls. States reported that pre-established communications channels were opened for the planned, daily “touch base” calls between CMS Desk Officers and state representatives.

States fielded calls from both individuals and stakeholders as to whether or not health insurances marketplaces and Medicaid would be opened due to the shutdown, as well as limited concerns over site functionality and apparent glitches. Medicaid reported that their efforts are focused on the closing deadline for open enrollment, rather than the earliest day to enroll, with the hope that they can spread out the overall volume of applications over a larger swath of time.

Some states reported taking a “phase-in” approach to standing up their eligibility systems as to limit the overall number of technical issues that occur, as well as to keep problems within manageable bounds. Data from the earliest efforts of open enrollment was limited and a clearer picture is likely to emerge in the coming weeks. There does, however, appear to be higher than expected interest in federally run Marketplaces.

The Federally Facilitated Marketplace (FFM), which manages the connection of states eligibility systems to the federal data hub, reported different experiences with the various states it was working to connect. In the first week of open enrollment, only a few states had the ability or were prepared to manage state to FFM data transfers, with more anticipating bringing their federal connectivity on board in the coming weeks.

More states anticipate brining, the “ping” federal data bug feature for certain data fields as their systems are fully stood up, depending on the duration of the partial federal government shutdown. Without a clear end to the shutdown in sight, it is difficult to determine how open enrollment will proceed. However, with higher than expected demand from consumers, the months of preparation that both government and private health IT professional had to prepare seems to finally be paying off. The open enrollment period runs through March 31st, 2014.